Executive order directs HHS to improve price transparency

President Donald Trump recently signed an executive order to direct HHS and other federal departments to revisit his first term efforts to improve price transparency in healthcare.

The Hospital Price Transparency final rule, which took effect on January 1, 2021, requires hospitals to list all prices online in the form of a machine-readable file (MRF), as well as a consumer-friendly display or tool for the 300 most common shoppable services.

The executive order directs HHS to take actionable steps on the following within 90 days:

• Require the disclosure of the actual prices of items and services, not estimates
• Issue updated guidance or proposed regulatory action ensuring pricing information is standardized and easily comparable across hospitals and health plans
• Issue guidance or proposed regulatory action updating enforcement policies designed to ensure compliance with the transparent reporting of complete, accurate, and meaningful data

In 2023, CMS updated its price transparency enforcement processes to require corrective action plan completion deadlines, impose civil monetary penalties earlier and automatically, and streamline the compliance process.

In the 2024 Outpatient Prospective Payment System final rule, CMS issued a multitude of new requirements with varied implementation deadlines. Over the last few years, hospitals have had to improve web page accessibility, conform to a specific template layout, encode new MRF data elements, and more.

Hospitals are continuing to struggle complying with price transparency requirements. In the latest edition of its semi-annual hospital price transparency report, PatientRightsAdvocate.org found that over three-quarters of hospitals were not in full compliance with federal regulations between July and November of 2024. The most common reasons for noncompliance include not passing the CMS validator tool, missing significant pricing data, not following template requirements, and failing to post a compliant .txt file, according to the report.

Revenue integrity professionals should review the report to learn more about common price transparency compliance issues.

Editor’s note: Find more NAHRI coverage of price transparency here.